title: Tuberculous encephalopathy without meningitis: pathology and brain MRI findings.
abstract: Tuberculous encephalopathy (TBE) is an established disease entity of diffuse cerebral damage occurring with tuberculosis and an underlying immune pathogenesis. However, the presence of this disease entity remains controversial. We report a 15-year-old boy with seizures and a progressive decline of cognitive function. Brain MRI showed diffuse, hyperintense lesions in the white matter on a T2-weighted image, with gadolinium enhancement on a T1-weighted image. Brain biopsy revealed demyelination and granuloma in the white matter. Ziehl-Neelsen staining showed acid-fast bacilli in the granulomas. Antituberculous medication with concomitant steroid treatment resulted in radiological resolution in addition to clinical improvement. Clinicopathological evidence in this case provides additional convincing evidence of TBE as a disease entity distinct from tuberculous meningitis.
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, 134 Sinchon-dong, Seoul, Republic of Korea.
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Kyu-Won
authors.initials: KW
authors.lastname: Shim
authors.forename: Moon-Kyu
authors.initials: MK
authors.lastname: Lee
authors.forename: Moo-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Eung-Yeop
authors.initials: EY
authors.lastname: Kim
authors.forename: Soochul
authors.initials: S
authors.lastname: Park
authors.forename: Tai-Seung
authors.initials: TS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology*; D003711:Demyelinating Diseases / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012640:Seizures / Q000209:etiology / Q000473:pathology; D016896:Treatment Outcome; D020306:Tuberculosis, Central Nervous System / Q000150:complications / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000995:Antitubercular Agents